Abstract：
OBJECTIVE: To investigate changes in analgesic use before and after participation in a digital first-line treatment program (exercise, patient education) in persons with knee or hip osteoarthritis (OA) and to explore associations between these changes in medication use and participant-reported pain and function.
METHODS: Retrospective cohort study with pre-post measures.
METHODS: Community setting.
METHODS: Individuals (N=4100; mean age ± SD, 64.5±9.3y; 73.3% women) participating in the digital program.
METHODS: A digital supervised education and exercise therapy.
METHODS: Self-reported analgesic use for knee/hip pain during the past month at baseline and 12-week follow-up, knee/hip numeric rating scale pain (0-10, a higher value indicating more pain), and Knee Injury and Osteoarthritis Outcome Score 12 or Hip Disability and Osteoarthritis Outcome Score 12 function subscale (0-100, higher values indicating better function). McNemar test, multivariable logistic regression, and linear random intercept model were used for statistical analyses.
RESULTS: Among participants, 61.4% and 49.4% were analgesic users at baseline and 12-week follow-up, respectively, (absolute reduction 12.0%; 95% confidence interval, 10.5-13.5). Being female, having hip OA, lower education, higher body mass index, living outside large metropolitan cities, coexisting rheumatoid arthritis, and walking difficulties were associated with higher odds of analgesic use at baseline. At both time points, persons not using analgesics at the time reported better outcomes. All groups but \"new users\" experienced improvements in their pain and function following participation in digital program with the greatest improvements observed among \"quitters.\"
CONCLUSIONS: Engaging in a digital exercise and patient education program as a primary treatment for knee or hip OA was associated with a reduction in the use of analgesics. The greatest improvements were seen for those who stopped analgesic use. These results highlight the importance of providing effective first-line treatment to people with knee or hip OA.
METHODS: Retrospective cohort study with pre-post measures.
METHODS: Community setting.
METHODS: Individuals (N=4100; mean age ± SD, 64.5±9.3y; 73.3% women) participating in the digital program.
METHODS: A digital supervised education and exercise therapy.
METHODS: Self-reported analgesic use for knee/hip pain during the past month at baseline and 12-week follow-up, knee/hip numeric rating scale pain (0-10, a higher value indicating more pain), and Knee Injury and Osteoarthritis Outcome Score 12 or Hip Disability and Osteoarthritis Outcome Score 12 function subscale (0-100, higher values indicating better function). McNemar test, multivariable logistic regression, and linear random intercept model were used for statistical analyses.
RESULTS: Among participants, 61.4% and 49.4% were analgesic users at baseline and 12-week follow-up, respectively, (absolute reduction 12.0%; 95% confidence interval, 10.5-13.5). Being female, having hip OA, lower education, higher body mass index, living outside large metropolitan cities, coexisting rheumatoid arthritis, and walking difficulties were associated with higher odds of analgesic use at baseline. At both time points, persons not using analgesics at the time reported better outcomes. All groups but \"new users\" experienced improvements in their pain and function following participation in digital program with the greatest improvements observed among \"quitters.\"
CONCLUSIONS: Engaging in a digital exercise and patient education program as a primary treatment for knee or hip OA was associated with a reduction in the use of analgesics. The greatest improvements were seen for those who stopped analgesic use. These results highlight the importance of providing effective first-line treatment to people with knee or hip OA.
摘要：
目的：调查膝关节或髋部OA患者参与数字一线治疗计划（运动和患者教育）前后镇痛药使用的变化，并探讨这些药物使用变化与参与者报告的疼痛和功能之间的关系。
方法：采用pre-post措施的回顾性队列研究。
方法：社区设置，瑞典。
方法：个人（n=4100，平均[SD]年龄64.5[9.3]，73.3％的女性）参加了数字计划。
方法：数字监督教育和运动疗法。
方法：在基线和12周随访的过去一个月中，膝盖/臀部疼痛的自我报告镇痛药使用情况，膝/髋NRS疼痛（0-10，较高的值表示更多的疼痛），和KOOS-12或HOOS-12功能子量表（0-100，值越高表示功能越好）。McNemar测试,采用多变量logistic回归和线性随机截距模型进行统计分析。
结果：在参与者中，在基线和12周随访时，有61.4%和49.4%为镇痛药使用者，分别,(绝对减少12.0%，95CI10.5，13.5）。作为女性，患有髋关节OA，教育水平较低,较高的体重指数，生活在大城市之外，共存的类风湿性关节炎，行走困难与基线时使用镇痛药的几率较高相关.在这两个时间点上,当时未使用镇痛药的患者报告结果较好.参加数字计划后，除“新用户”外，所有小组的痛苦和功能都得到了改善，在“戒烟者”中观察到的改善最大。
结论：参与数字运动和患者教育计划作为膝或髋骨关节炎的主要治疗与止痛药使用的减少有关。对于那些停止使用镇痛药的人，可以看到最大的改善。这些结果强调了为膝关节或髋关节OA患者提供有效一线治疗的重要性。
方法：采用pre-post措施的回顾性队列研究。
方法：社区设置，瑞典。
方法：个人（n=4100，平均[SD]年龄64.5[9.3]，73.3％的女性）参加了数字计划。
方法：数字监督教育和运动疗法。
方法：在基线和12周随访的过去一个月中，膝盖/臀部疼痛的自我报告镇痛药使用情况，膝/髋NRS疼痛（0-10，较高的值表示更多的疼痛），和KOOS-12或HOOS-12功能子量表（0-100，值越高表示功能越好）。McNemar测试,采用多变量logistic回归和线性随机截距模型进行统计分析。
结果：在参与者中，在基线和12周随访时，有61.4%和49.4%为镇痛药使用者，分别,(绝对减少12.0%，95CI10.5，13.5）。作为女性，患有髋关节OA，教育水平较低,较高的体重指数，生活在大城市之外，共存的类风湿性关节炎，行走困难与基线时使用镇痛药的几率较高相关.在这两个时间点上,当时未使用镇痛药的患者报告结果较好.参加数字计划后，除“新用户”外，所有小组的痛苦和功能都得到了改善，在“戒烟者”中观察到的改善最大。
结论：参与数字运动和患者教育计划作为膝或髋骨关节炎的主要治疗与止痛药使用的减少有关。对于那些停止使用镇痛药的人，可以看到最大的改善。这些结果强调了为膝关节或髋关节OA患者提供有效一线治疗的重要性。
